PT  - JOURNAL ARTICLE
AU  - Riya Tharakan
AU  - Sujonitha John
AU  - Jaidev Mangalore Devdas
AU  - Pavan Hegde
TI  - Isolated hepatosplenic tuberculosis: a rare presentation with persistent fever in a 2-year-old female child
AID  - 10.1136/bcr-2021-243851
DP  - 2021 Aug 01
TA  - BMJ Case Reports
PG  - e243851
VI  - 14
IP  - 8
4099  - http://casereports.bmj.com/content/14/8/e243851.short
4100  - http://casereports.bmj.com/content/14/8/e243851.full
SO  - BMJ Case Reports2021 Aug 01; 14
AB  - A 2-year-old female child from South India presented with persistent fever for 3 weeks, pallor and hepatosplenomegaly. There was no history of contact with tuberculosis (TB) and BCG scar was absent. Tests for TB (Mantoux and gastric aspirate) were negative. Blood and bone marrow tests for other infections, inflammation and infiltration were inconclusive. Chest X-ray was normal. Ultrasound study (USS) of abdomen showed multiple microabscesses in the liver and spleen. USS-guided fine needle aspiration cytology from splenic lesion demonstrated epithelioid granuloma while bacteriology was negative. Commencement of anti-tubercular therapy (ATT) resulted in remarkable clinical improvement in a week with resolution of lesions on follow-up USS in 2 months. Isolated hepatosplenic TB in children, though rare, has a wide, non-specific clinical spectrum and potential of delaying diagnosis. Probability diagnosis and therapeutic trials of ATT are accepted approaches, using treatment response as indirect confirmation of the likely cause.